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Given a referral to a specialist, I wonder about seeing yet another physician. My PCP is great; I trust that he’s sending me to a good doctor, but I’m still curious what to expect. What does the person look like? Which med school? How old/experienced is the doctor? Am I going to get lost trying to find the office?

Google can be great answering those questions. It’s nice to type in the doctor’s name and find the practice’s website: physician name, photo, CV, office hours, driving directions. Everything I want to know is there. I don’t have to interrupt the receptionist to get my answers.

When I was sent to an orthopedist, it was a bonus that the practice’s website was linked to their EMR. Instead of phoning the office to set up an appointment and asking them to snail-mail me all the paperwork in advance, I was able to request an appointment online and fill-in-the-blanks electronically instead of filling out the paperwork longhand. It was great!

At least it was great until I arrived for my appointment. At check-in they confirmed everything I’d entered online, then handed me a ream of paperwork and explained that they were in the process of switching from paper charts to electronic, and needed everyone to fill in all the bubbles so that the information could be scanned into the computer. When I pointed to her printouts and reminded her that my information was already in the new system, she took the Nazi defense (I’m just doing what I was told).

I spent 25 minutes filling out all the paperwork, repeating the information I’d entered online the week before and just confirmed at the check-in desk.

When I finally got to see the doctor, he had a paper chart in his hands, and I discovered that it was just the front office transitioning to EMR at that time. Despite the doctor accusing me of being type-A, the visit went well.* He did his exam, provided a treatment plan, and had me schedule a follow-up appointment.

When I returned eight weeks later, I was there the day the doctors went live with their new EMR. Rather, they tried to go live. Nobody was able to log in. Lucky me.

My first appointment with him had gone well, but the second one was a disaster. Even though I was the first appointment of the day, I sat in the waiting room an extra thirty minutes. At 8:30 in the morning the doctor was already two patients behind, and finally decided to see patients whether the computer was working or not. Unfortunately, the paper charts weren’t available. The MA had jotted down some basic notes, but it was obvious that it didn’t give the doctor enough information to work with. With no paper chart and no EMR, the doctor walked into the room having only a vague idea who I was, why I was there, and what he was following up on. He didn’t even know if the consultation note he’d been waiting for had arrived (it had, but I paid a whole lot of money to hear that he wouldn’t know what it said until they could get the computer working).

That’s a huge drawback to reliance on a computer. When your system is down, does everything come to a grinding halt?

There needs to be a backup plan. If the power is out, preventing computer access, it’s a problem. If the software has a glitch, everyone’s stuck. If patient records are half-way across the country and there’s a storm preventing internet access, patients might not get the treatment they need. It doesn’t really matter what the excuse is. If my doctor had stuck with paper charts, he would have had all the information he needed right at his fingertips.

The right software will make your job easier, not harder. If it won’t easily give you the information you need when you need it, then it’s not the right software for you. Computers are great tools, but they’re just tools. Think of other tools. I can grab a butter knife to tighten screws, but it’s easier (and more well done) to use a screwdriver.

Regardless of what business you’re in, smart shoppers don’t buy a database just so they can claim they’re computerized. First figure out what information you need to keep track of and what you want to do with it, then find a program that meets the criteria. That’s step one.

Step two is to invest in training. You can figure out a $40 program from an instruction manual, but quality high-end programs should include training and transition assistance in the purchase contract.

Thorough training is essential. So is a backup plan. My orthopedist didn’t have either one. I hate his EMR.

:) How do you deal with it when they don’t complete the forms correctly, even though you’ve provided the information? I saw someone a couple weeks ago who didn’t appreciate my “see attached” and wanted everything in their tiny little boxes. The MA scanned through my typed sheet and transferred part of the information, to their form, but not all of it. The doctor saw that the MA had added things to the form, so wouldn’t look at my attached sheet.

I was lucky to find this warmsocks.wordpress.com site.
I have to say that it’s a swell blog! I admire how determined each of the entries are. They are well balanced – fun and informatory – and the pictures are cool too.